This is a place to share issues, useful and helpful information regarding healthy communities - what are some of the community programs that are helping our people address these issues, both on-reserve and in the towns and cities? Traditional and Contemporary solutions?

Key Messages• Racism and colonization are intertwined (Reading, 2013) and together deeply impact the health ofIndigenous peoples in Canada. Both in Canada and internationally, colonization has been recognizedas a having a fundamental impact on the health of Indigenous peoples (Cunningham, 2009; Mowbray,2007).• At the individual, family and community level, Indigenous peoples have been managing racism andits impacts on health and well-being for hundreds of years, demonstrating resilience in the face ofviolence, cultural genocide, legislated segregation, appropriation of lands and social and economicoppression.• The stories of Indigenous health in Canada told in the mainstream society are generally not authoredby Indigenous peoples themselves, and are often characterized by racist stereotypes and images(Browne, 2003, 2005; Clark, 2007; Gilchrist, 2010; Neegan, 2005; Watters, 2007). This paper offers anIndigenous perspective on the experiences and impacts of racism on Indigenous health and well-being.• Information about Indigenous health cannot be understood outside of the context of colonial policiesand practices both past and present. This includes:- The Indian Act (1876) and related policies and processes, which served to: 1) dispossessIndigenous peoples of land and disrupt traditional economies thereby cutting off sources offood and manufacturing food dependence on colonial authorities (e.g. restricting hunting andgathering practices by restricting mobility) (Smylie, 2009); 2) give colonial authorities the powerto determine who could be an “Indian”; 3) impede the transmission of identity and traditionalknowledge (Bourassa & Peach, 2009; Lawrence, 2004; Smylie, 2009); and 4) undermine the rolesand responsibilities of women in previously matriarchal and/or matrilineal societies (Blair, 2005;Stevenson, 2011; Furi & Wherrett, 2003).- The forced relocation of Inuit peoples and the imposition of permanent settlements, compoundedfor some communities by the mass slaughter of sled dogs (Brennan, 2012; Smylie, 2009).- The residential school system, which subjected generations of children to sexual, emotional,physical, mental, spiritual and cultural abuse.- Historical and current child welfare processes, which have and continue to separate substantialnumbers of children from their families and communities.• The process of colonization has resulted in ongoing and entrenched racism against Indigenouspeoples. Racist ideologies continue to significantly affect the health and well-being of Indigenouspeoples, cutting across the social determinants of health, impacting access to education, housing,food security and employment, and permeating societal systems and institutions including the healthcare, child welfare and criminal justice systems.• In the case of health care, barriers to access for Indigenous peoples include:- Racism within the health care system. Research shows that racism against Indigenous peoplesin the health care system is so pervasive that people strategize around anticipated racism beforevisiting the emergency department or, in some cases, avoid care altogether (Kurtz et al., 2008;Tang & Browne, 2008; Browne et al, 2011).- The Non-Insured Health Benefits (NIHB) Program – which provides medical goods and servicesfor status First Nations and Inuit people. The NIHB excludes Métis and non-status First Nations(Bent, Havelock & Haworth-Brockman, 2007; Bourassa & Peach, 2009; Ghosh & Spitzer, 2014;Haworth-Brockman, Bent & Havelock, 2009; Wilson et al., 2013). It also presents barriers tothose who are eligible by requiring on-reserve residency for some services, continually curtailingapproved medications and treatments, and limiting access due to onerous approval processeschanging (Haworth-Brockman et al., 2009; Mother of Red Nations, 2006). Moreover, the deliveryof NIHB poses challenges to equitable access to health services in comparison to non-Indigenouspeople, particularly in northern and remote communities.• Promising and emerging responses include:- Indigenous directed health and health related services.- Efforts to increase the number of Indigenous health care providers.- The employment of specialized roles such as Indigenous patient navigators to serve as a bridgebetween Indigenous patients and the health care system.- Cultural safety training. While cultural sensitivity and cultural competence focus on learningabout the culture of the service user, cultural safety pays explicit attention to power relationsbetween service user and service provider.- Trauma-informed care, which takes up the impacts of historic, collective and intergenerationaltrauma and is reflected both through encounters with individual providers and the approach oforganizations.- Interventions addressing implicit bias. Research from the United States (US) demonstrates thatunconscious, pro-white bias on the part of health care providers results in health inequities forracialized patients (Blair et al., 2013; Green et al., 2007), and that effective interventions can bedesigned to begin to erode this bias.• Critical next steps include:- Reframe the conversation around race and health in Canada by acknowledging the foundationaland ongoing realities of racism and colonialism (Lawrence and Dua, 2005), which are obscuredby the official framing of the Canadian nation as a harmonious multicultural mosaic.- Generate meaningful data in order to understand and address the role of racism in the healthdisparities experienced by Indigenous peoples in Canada (Paradies et al., 2008).- Develop or adapt effective interventions to address attitudinal, interpersonal and systemic racismtowards Indigenous peoples.- Pursue bold and brave evaluations of existing anti-racism strategies and interventions.http://www.wellesleyinstitute.com/wp-content/uploads/2015/02/Report-First-Peoples-Second-Class-Treatment-Final.pdf